5 Ultra-Truths You Should Know Before You Get That IUD

Clearing Up Some Common Concerns

In my practice, I have noticed a huge increase in the popularity of IUDs (Intra-Uterine Device) as a birth control option. More and more women are coming in asking about it, and are deciding to go for it. You may have a girlfriend or two who already has an IUD – and there’s a good chance she raves about it. Word-of-mouth has been a major factor in the growing numbers of IUD users. Truth be told, it’s an excellent option for contraception. At the same time, there are a few issues that commonly hold women back. Things that some of us find concerning, weird, or downright creepy.

If the convenience and effectiveness of an IUD has you intrigued, but you’re kind of creeped out by one of the issues below…read on.

1. The Pain

Let’s tackle this one right off the bat. Many women are concerned about the amount of pain they may have during insertion, and also have questions about whether they’ll feel the IUD once it’s in place.

Inserting an IUD is an in-office procedure that takes about the same time as a Pap. The IUD gets inserted through the cervix, which needs to be dilated a little first. Granted, this can be uncomfortable. But there’s a wide spectrum of the degree of discomfort women experience during the procedure. It’s true, for some women it can be painful. But the pain of insertion is brief – typically just a few moments. And then it’s done. For up to five years. Most women agree it’s a pretty small price to pay.

That said, some clinics have the ability to anesthetize the cervix beforehand, so if you’re really worried about insertion pain, look for a clinic that provides this service.

After insertion, it’s normal to have some cramping and spotting. This can last for a day or so, or sometimes a little longer. Because the IUD sits within your uterus, you should not be able to feel it once it’s inserted. And, as long as the strings have been cut to the correct length, your partner should not be able to feel it during intercourse.

And what about painful periods? Well, I’ll tackle this issue farther down.

2. The Hormones

Many women are concerned about exposure to hormones. First, it’s important to distinguish between the two kinds of IUDs. There are copper IUDs (which contain no hormones) and progestin-containing IUDs (the most common brand name is Mirena). There is no estrogen in Mirena, only progestin. Mirena releases a small amount of progestin into the tissues of your uterus at a slow and steady rate. Very little is actually absorbed into your bloodstream. That said, some women do experience hormone-related side effects, like acne, nausea, weight gain, and mood changes. The main effect you will likely experience with Mirena, however, will be changes to your period. Which is what I’ll tackle next.

3. The Changes to Your Periods

The effect on your period will depend on a few factors, including the kind of IUD you choose.

If you decide to go for the progestin-containing IUD, like Mirena, you will probably find that your period is substantially lighter than usual – and may, over time, disappear completely. This is because of the hormonal effect on the lining of the uterus: it prevents the normal monthly thickening of the lining. The response can vary, however. Some women with Mirena experience irregular spotting and bleeding that occurs at inconvenient times.

If you get the copper IUD, because there’s no hormone, you’ll cycle as you would when not taking any form of birth control. But the copper IUD can make your period heavier and somewhat crampier. Sometimes it can be a lot heavier and more painful. Again, everyone is different.

4. The Strings

For some women, the mere idea of strings hanging out your cervix is a creepy one. The strings exist to facilitate removal when the time comes – sort of like a tampon, except that the IUD sits within the uterus, not the vagina (here’s a diagram, so you can visualize it better). Ideally, you should be able to check yourself and feel the strings just outside the cervix. But not all women can do this—it requires a certain degree of flexibility and comfort with your own body.

No worries if you can’t do it. If you’re not sure, just see your doctor who can examine you and make sure the strings are visible.

5. The Package (When you go to pick it up)

Let’s say you’ve made the decision to go for it. One final hurdle: picking up the IUD package at the pharmacy.

It’s HUGE. Do not be alarmed.

Know this: the IUD itself is small, about 3 cm in length. It’s the insertion device that is quite long, over a foot in length. Remember, the insertion process is brief, and once it’s in place, you won’t feel your IUD. Don’t let the gigantic package stop you from doing what you’ve already decided to do!

Now you tell me: Tell me: is an IUD something you would consider? If you already have an IUD—are you happy with it?

Kim Foster, MD, is a family doctor, writer and mom. She is passionate about healthy living and preventive health. That passion notably includes chocolate. And pinot noir.

As a mother, Dr. Kim knows how hard it is to make healthy choices…when ordering takeout is just so damn easy. She is dedicated to helping moms find that sweet spot between positive lifestyle habits and the little indulgences that make life pleasurable.

At YMC she’ll be blogging a sparkling cocktail of health advice. But no preaching. Dr. Kim knows that not everything works for everybody. And don’t stress over “perfect”. Balance is a nice ideal but, really, only critical when crossing a room in four-inch heels.